Uncategorized Archives

Diagnostic Musculoskeletal Ultrasound

Diagnostic Musculoskeletal Ultrasound PM&R News • April 2022 Ultrasound for the diagnosis of musculoskeletal pathology is becoming increasingly widespread. However, many clinics still do not have a standardized method for documenting diagnostic ultrasound procedures. We have generated several basic diagnostic ultrasound templates for use by Physiatrist to assist with appropriate documentation that can communicate findings, and help providers capture charges for work performed in the assessment of the patient. Please see these templates as listed below: Limited Diagnostic Ultrasound of the ***, Performed by Dr. *** during their clinic visit on **/**/**** A 2D, gray scale B mode ultrasound limited ultrasound of the *** [...]

Diagnostic Musculoskeletal Ultrasoundashpt2022-04-25T01:40:54+00:00

Congratulations on the Job!

Congratulations! PM&R News • July 13, 2021 You are done Residency! Some of you are done Fellowship! Part I is about to be completed! You may be done both board exams! Check….. Check…. Check…. Now this is the time you all have been anxiously awaiting… being a “real” doctor! Your first attending job! However, this may be the toughest challenge yet! The transition from medical school to Internship was tiring! Internship to Rehab Residency… Hard! Residency to fellowship… what a change of pace! But now, it’s all on YOU! I feel the biggest challenge is your first job! You are now finally [...]

Congratulations on the Job!David Impastato, MD2021-07-13T13:26:17+00:00

Blood Pressure Management in Stroke

Blood Pressure Management in Stroke PM&R News • June 2021 Goals: A balance of cerebral perfusion and ischemia BP <140/90 mmHg Antihypertensives restarted in neurologically stable patients ~24-48 hrs UTD recommendation: after large artery stenosis is excluded and after vascular imaging performed For large artery: timeframe is 7-14 days Timeframe goal: few days – few weeks Ischemic rtPA not administered: do not lower BP in first 24 hrs unless it exceeds 220/120 OR active: ischemic coronary disease, heart failure, aortic dissection, hypertensive encephalopathy, or pre-eclampsia/eclampsia Prior to rtPA administration: BP <185/110 After rtPA administration: BP < 180/105 for 24 hours. Monitoring: 1st 2 [...]

Blood Pressure Management in Strokeashpt2021-06-19T23:21:57+00:00

Dysphagia and CVA

How can we improve swallowing in the patient with hemiparesis? PM&R News • February 2019 A study on the effects of cerebrovascular accident (CVA) related to cervical alignment and its effects on dysphagia has recently been published in the European Journal of Physical and Rehabilitation Medicine. The study wanted to analyze if the use of cervical isometric exercises could improve dysphagia in those who had recently been affected by hemiparesis. In order to compare the experimental and control groups radiographs were taken in an upright position pre and post-testing along with a deglutition study to evaluate swallowing. Participants: 70 dysphagic patients with hemiparesis [...]

Dysphagia and CVAashpt2019-02-21T02:40:38+00:00

Atrial Fibrillation in Endurance Athletes

Atrial Fibrillation in Endurance Athletes PM&R News • December 2018 With “Holiday Heart” season upon us, it seems appropriate to have a discussion about Atrial fibrillation. Atrial fibrillation (AF) is most commonly seen in older men and is generally associated with cardiac risk factors including hypertension and coronary artery disease leading to structural changes in the heart. However, several studies have also identified an association of paroxysmal AF in young to middle aged endurance athletes. So, if you were planning to keep your heart healthy this holiday season with marathon training or 100-mile bike rides, you may not be completely out of the woods. [...]

Atrial Fibrillation in Endurance AthletesDavid Impastato, MD2019-08-11T19:49:33+00:00